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When even sleeping is a pain…

Do you get enough sleep? Are there ways to get more?

The latest Sleep Poll conducted by the National Sleep Foundation says that patients with pain are typically operating on a sleep deficit. That is, those who suffer chronic or acute pain report that they regularly sleep for less than they think they need. When asked to quantify their sleep deficits, the average deficit is 42 minutes.

The study indicates that the sleep deficit can be attacked, but it takes motivated sleep behaviors. “Taking control of your sleep by being motivated, setting a routine bedtime and creating a supportive sleep environment are relevant even for those with pain,” said David Cloud, CEO of the National Sleep Foundation.

Sleep issues affect many adults at various times in their lives, but has the greatest impact on those with chronic pain. Twenty-three percent (23%) of chronic pain sufferers say that they have actually been diagnosed with a sleep disorder.

The National Sleep Foundation report also indicates that restorative, sufficient sleep is another indicator of good health. As you might expect, those whose health is good tend to report better sleep while those who have health concerns tend to report poorer sleep. And to add insult to injury, those who are at highest risk for developing chronic pain reported significant sleep deficits.

If you are running at a sleep deficit, what can you do?

Prioritize getting better sleep, moving it to do your to-do list. Understanding that you need to have a bedtime that allows you to get seven to nine hours of sleep is key.
Create bedtime routines that will bring you success. Go to bed in your bed at a reasonable bedtime. Unplug from all screens, both small and large. Switch to old-fashioned books before bed, the less stimulating the better.
Evaluate your sleep environment and make changes that work. People in pain tend to blame environmental aspects on their poor sleep. They tend to be more irritated by the condition of the mattress, the temperature, too much light or ambient noise. If these bother you, take steps to improve them, whether it means investing in new bedding, purchasing a fan, getting earplugs or eyeshades, soundproofing your environment or adding white noise into your bedroom environment.
Healthy lifestyle choices beget better sleep. Choose more healthful food options, exercise regularly, limit or quit smoking and reduce alcohol intake.

The complete 2015 Summary of Findings report can be downloaded at http://sleepfoundation.org/sleep-polls-data/2015-sleep-and-pain. The National Sleep Foundation releases its yearly poll to coincide with National Sleep Week, which occurs just prior to Daylight Savings Time.

Osteoporosis, What Women AND MEN Need to Know, Part II

You can’t always prevent osteoporosis. There appears to be a genetic component, making certain people more predisposed to the disease. But physicians and researchers agree that you may be able to delay the onset of osteoporosis, lessen its impact or manage the complications of osteoporosis through some healthy living choices, including nutrition (which was discussed in a previous blog), exercise and making better health decisions.

Quitting smoking is always a sound health decision. Smoking causes lung cancer. But in addition, smoking affects all aspects of your body functioning, from the way that your heart pumps blood throughout the body and even how your bones absorb nutrients. Even if you have been a lifelong smoker, you can still accrue health benefits from quitting smoking today.

Avoid excessive use of alcohol. Alcohol intake interferes with the balance of calcium in your body. Alcohol abuse may also be implicated in the under-production of hormones. Hormones protect your bones, which is why post-menopausal women are at greater risk for osteoporosis. Alcohol abuse which leads to blackouts and falls puts you at greater risk for fractures.

photo by Rudolph A. Furtado

Exercise regularly and do the right kind of exercises.

In general, osteoporotics should avoid high-impact exercises, even though these can contribute positively to bone health and overall cardiovascular health, because of their higher risk for bone breakage.

Engage in weight-bearing exercises and muscle strengthening exercises regularly. Some good choices are:

walking at a quick pace indoors or outdoors or on a treadmill (still the cheapest and most popular form of exercise)
use of an elliptical machine
low impact aerobics
water aerobics that include use of weights
circuit training
weight lifting (particularly lower weights with higher repetitions)
exercising with resistance elastic bands
utilizing weight machines
modified yoga or pilates, specially designed for osteoporosis patients (not all forms and positions are safe)
Tai Chi
Functional exercises: if you have trouble walking up and down the stairs, practice this as your exercise. If getting up and down from various couches and chairs feels like exercise, turn it into your exercise!

Exercise needs to become part of your daily routine. You should start slowly, but you should attempt to exercise daily. Try to work your way up to 30 minutes per day in weight-bearing and/or muscle strengthening activities.

Before starting any exercise program, consult your health care provider.

Acai Berries: Probably Healthful, Definitely Delicious

A patient asked us recently what we knew about the purported “super food” qualities of the acai (ah-sigh-EE) berry. After we did some research, here’s what we found out: The acai berry comes from the acai palm tree and is native to Central and South America. It is a relative of the blueberry, the cranberry, pomegranates and other dark purple-hued fruits. Much research and even more media attention toward the acai berry has focused on the fruit’s antioxidant properties that appear to protect cells. While many people support eating acai berries to address various health conditions, so far acai berries have no clinically proven health benefits that are any different than the benefits of other similar fruits. There are a number of smoothie recipes featuring acai berry juice or whole acai berries. Here is one of our favorites:

Cherry-Acai Green Smoothie Recipe

2 small bananas, peeled
1 bag (10-16 ounces) whole, frozen, acai berries
1 cup fresh of frozen cherries
4 ounces of water

Blend on high for 30 seconds or until the smoothie is creamy.

Variations:

You can easily turn this recipe “green” (although it will come out brown) with the addition of your favorite leafy green. Boost the mineral content with a handful of fresh baby spinach, fresh baby kale or be adventurous with some bitter, cleansing dandelion greens.

To enhance the tropical flavor notes, use fresh coconut water instead of regular water.

Nutrition Information

Calories: 357
Fat: 7g
Protein: 6g
Carbohydrates: 75g
Fiber: 11.5g
Calcium: 7% RDA (Recommended Daily Allowance)
Iron: 1.1mg
Vitamin A: 42% RDA
Vitamin C: 44% RDA

Source for this, and other smoothie recipes featuring acai: http://www.incrediblesmoothies.com/recipes/cherry-acai-antioxidant-smoothie-recipe/

What Does A Chiropractor Do?

The easy answer is: a lot!

The goals of chiropractic treatment are relief of acute pain, management of chronic pain, education of patients on self-care and prevention of further injury or pain.

Chiropractic care can be a very effective element of pain relief treatment, particularly when it is a component of a multi-pronged treatment plan. Chiropractic care is particularly appropriate in treating the following conditions:

Back Pain
Neck Pain
Headaches
Disc Injuries
Pinched Nerves
Sciatica
Radiating Pain
Strains and Sprains
Muscle and Joint Problems

Chiropractors utilize a variety of techniques to obtain results for their patients.

The chiropractic treatment that people seem to be the most familiar with is chiropractic adjustment and manipulation. This is one of the most effective tools for pain reduction that a chiropractor can offer. Indeed, manual manipulation can give more relief, and lasting relief, than other therapeutic interventions, including drugs, particularly in the case of acute musculoskeletal pain.

Other treatments include:

Disc Compression/Flexion Distraction/Cox Therapy are related manipulation treatments that are utilized to decompress spinal joints and discs. A specialized piece of equipment, the Hill AirFlex table, allows us to coordinate hands on treatment with decompression traction to the spine. This technique can be used for treatment with disc problems, facet joint syndrome, lumbar stenosis, scoliosis and spondylolisthesis.

Massage Therapy/Trigger Point Therapy/Myofascial Release, Active Release Technique: These hands-on techniques are applied to areas of muscular pain and tension. They are used to help mobilize the soft tissues and adhesions, and include deep pressure and stretching procedures applied to sensitive points that are commonly found in the muscles.

Joint Mobilization Therapy: This therapy involves a deep stretching movement applied to the joints, ligaments, muscles, tendons and discs. These treatments work to restore mobility, range of motion, relax tight muscles, and help limit disability and pain.

McKenzie Technique: This patient education regimen includes teaching patients back care basics, correct posture principles and specialized stretching and exercises to help prevent and care for neck and back-related pain. Through individualized instruction patients learn ways to apply self-care treatments at home to help facilitate their rehabilitation and recovery.

Spinal Core Stabilization: These are exercises and stretches, prescribed to help strengthen the muscles that support the spine for improved control of body movements. Stabilization exercise works to help relieve pain, improve flexibility and limit the chance for re-injury and further bouts of pain.

National Pain Report Published

A note from Dr. Bleiberg’s staff: if you are a Michigan Spine and Pain patient who participated in this survey and would like to share your involvement in or personal observations of this important report, please feel free to share your thoughts with us. All comments, responses or observations by our patients to the Women In Pain Survey will be kept in the strictest of confidence.

Breaking News Press Release: Friday September 12, 2014

The National Pain Report today released its survey results on Women in Pain. More than 2,400 women who suffer from chronic pain completed the survey. It is the largest survey response we have ever had. We’re not surprised, because this is a very important and under-reported topic. We learned many things. For instance: 90% of women feel they have been discriminated against by the healthcare system. Eighty-four percent (84%) feel they have been treated differently by doctors because they are women.

We invite you to see the results of the entire survey on the National Pain Report website: Women in Pain Survey Results. (There’s a response section at the end of the survey. If you have thoughts, share them and we might use some of them in future news content.)

By the way, we shared these results this morning (Friday) in Los Angeles at the annual meeting of our survey partner, For Grace, which is a nonprofit dedicated to the issue of women in pain.

Thank you again for participating and for supporting the National Pain Report, the largest online news site dedicated to covering chronic pain.

Best Wishes,

Ed Coghlan, CEO, National Pain Report

Taking Time with You; Using Time with Us Wisely

This story: 15-Minute Visits Take A Toll On The Doctor-Patient Relationship posted on the Kaiser Health News web site got our attention. (You can see the full story here: www.kaiserhealthnews.org/stories/2014/april/21/15-minute-doctor-visits.aspx)

Both doctors and patients are feeling the stress from the decreasing amount of minutes that physicians under pressure are able to spend in an exam room one-on-one with the patients they care for. Did you know that the average amount of time physicians spends with a patient is right around 8 minutes per patient, according to a 2013 study reported on in the New York Times?

At Michigan Spine and Pain we spend the time we need to with our patients, even if that means our time with you is ten times the “new doctor national average” reported in the NYT study. The reality, though, is that your time with the doctor is limited. Preparing a list of questions can help you make the most of the window of time you have together. You can help facilitate a truly productive visit with your doctor if you write down your symptoms prior to your appointment and you:

*Bring the name(s) and contact information for any doctor(s) you have seen in the last year.

* Bring a list, with dosage information, for all medications you are taking. This goes for over the counter medicine, vitamins and supplements too.

And ask these types of questions:

What are some of the possible causes for my symptoms?
What kinds of tests might confirm a diagnosis you suspect?
What treatments are available, and which do you recommend?
What types of side effects can I expect from treatment?
How can I best manage other health conditions I have?
Are there any restrictions that I need to follow?
Are there any alternative therapies other than the approach that you’re suggesting?
Is there a generic alternative to the medicine you’re prescribing me?
Is there educational material I can take home with me? What websites do you recommend visiting?

Aches and Pains? Is It Fibromyalgia?

Fibromyalgia is a disorder whose chief symptom is pain, the kind of pain that is called musculoskeletal pain (in the muscles, bones and joints).

The other significant symptoms of Fibromyalgia are intense fatigue, difficulty sleeping, problems with memory and severe moods (either swinging between highs and lows or even a vague depression).

Fibromyalgia is a very complicated disorder. Sometimes it evidences itself after a physical or emotional trauma, sometimes it shows up after a medical procedure, and sometimes there appears to be no “trigger”.

You could be at risk for Fibromyalgia if you have rheumatic diseases. Fibromyalgia is more prevalent in women.

Diagnosing Fibromyalgia:

Fibromyalgia can be tricky to diagnose. In general, fibromyalgia will be suspected if you experience pain, often in the form of a dull ache, pain that does not go away for at least three months. The pain needs to be experienced in multiple locations, on both the left and right sides of the body and both above and below the waist.

Treating Fibromyalgia:

At Michigan Spine and Pain, we are aware that Fibromyalgia treatment must be individualized. We cannot eradicate Fibromyalgia, but we can work together to try to keep the symptoms at bay through therapies, medication and maintaining a good level of general health, through proper diet, exercise and restorative sleep schedules.

Medication can be as simple as over the counter pain relievers, prescription pain relievers, certain anti-depressants, medication to aid in sleeping better or certain anti-seizure medication. All of these substances need to be monitored and part of regular conversation between you and your health care provider, so we can be sure that the medication is effective and is not creating other unwanted side effects.

Medication and healthy life style maintenance are two parts of the puzzle. Often times, other interventions can be quite helpful, too, including psychological counseling to find strategies to decrease stress, physical therapy to learn gentle stretching exercises that can help, acupuncture and massage therapy.

Swimming Away from Back Pain

For those who suffer from back pain, it is imperative to lead an active lifestyle.

Finding an exercise that maintains activity levels, burns calories and builds muscle is key. Swimming accomplishes all three. Swimming takes all of the stress off of joints. And swimming can strengthen back muscles and core muscles. In addition, swimming has been documented to reduce back pain.

But not all swimming is created equal.

If you are suffering from back pain, you should not begin a swimming regimen or any exercise routine without consulting your health care provider.

If you are cleared to swim, you may want to engage a coach, instructor or trainer to look at your stroke and to be sure that you are not twisting too much and are working efficiently.

The best swimming strokes for pain patients are the breaststroke and the backstroke. Both of these are better than the butterfly and crawl, which utilize a more “twisty” motion.

If you and your doctor decide that swimming is for you, start your exercise routine slowly and increase incrementally. According to the New York Times, “Japanese researchers looked at 35 people with low back pain who were enrolled in an aquatic exercise program, which included swimming and walking in a pool. Almost all of the patients showed improvements after six months, but the researchers found that those who participated at least twice weekly showed more significant improvements than those who went only once a week. The improvement in physical score was independent of the initial ability in swimming.”

Treating Pregnancy Low Back Pain

Previously, we talked about the high incidence of low back pain in pregnant women, especially in the final trimester of pregnancy, and some basic ways to prevent low-back pain. We hope that you will be able to prevent back pain.

If, despite your efforts, back pain arrives, let’s talk about what you can do or how we can help:

Physical therapy: If your back pain is unbearable, we encourage you to make an appointment with our physical therapist. We can recommend exercises for you and watch you practice while you’re in the office. That way, we can be sure your position and movements are safe and appropriate. These exercises can be to prevent pain or for when back pain flares up.
Posture check: When you come into our office, we can also show you the best ways to sit and stand that will allow you to keep back pain at bay.
Pain medication: check with us regarding what drugs are allowed for pregnant women.
Sometimes, applying heat or cold can alleviate back pain. Come see us before starting this regimen. Often several days of cold compresses followed by a few days of heat applied to the low back can bring some relief. Never apply heat to your stomach.
Psychological support: in our offices, we understand that the physical and the mental aspects of pain are interrelated. If you are under stress (and pregnancy, even a well-planned, expected one can be stressful), you may need some counseling to help you through this transition.
Chiropractic adjustment: this procedure can be safe during pregnancy and can really help diminish pain.
Acupuncture: this complementary medical approach, inserting small needles into the skin, also can be a source of relief for many of our patients.
Support Belt: there is not great evidence that these support belts are effective; nevertheless, if it works for you, there’s no danger in trying one on (except the cost of buying one).

Give us a call and let us help you if your lower back pain is more than you can bear.

IMPORTANT NOTE: ANYTIME you are ever concerned that the feeling or sensation you have while pregnant is questionable, call your obstetrician immediately. Pain accompanied by vaginal bleeding, fever or burning during urination may be very serious. If this occurs, contact your obstetrician immediately.

Adding Chocolate to Your Health Care Plan

Let the Cheering Commence: Chocolate is Good for Your Heart and can Ease Pain!

There has been an explosion of interest – and now a continuous flow of evidence-based research – on the overall benefits of chocolate, especially when consumed in moderation and as part of an overall healthy lifestyle. “The luscious aroma, taste and textures of chocolate have delighted the senses of people in many parts of the world for centuries and make it a well-known comfort food,” commented Sunil Kochhar, Ph.D. during the Cocoa: Science and Technology symposium held at the March 2014 National Meeting & Exposition of the American Chemical Society.(source: www.acs.org/content/acs/en/pressroom/newsreleases/2012/march/science-celebrates-cocoa-and-chocolates-potential-health-benefits.html)

Physical pain can take an emotional toll on a person. Now, scientists have discovered that chocolate can help with that, too! Perhaps even more interesting than the comfort-food qualities of chocolate, though, is the emerging understanding that “Dark chocolate can relieve stress for some people” and that “chocolate may be useful in treating of diseases involving disorders of the trigeminal nerve, including migraine and temporomandibular joint (TMJ) disorder.” (source: www.acs.org/content/acs/en/pressroom/newsreleases/2012/march/science-celebrates-cocoa-and-chocolates-potential-health-benefits.html In addition to reducing stress, providing comfort and positively influencing certain nerve components connected with TMJ, researchers are continuing to look at scientifically significant laboratory results indicating chocolate eating’s positive correlation with diseases and conditions. The list of potential physiological benefits is even longer than we have time for here. But here are a few currently being studied:

fighting cardiovascular problems
preventing clot formation
protecting livers from damage that can lead to liver disease
reducing high blood pressure – a major heart disease risk
reducing the risk of colon cancer

Adding to the good news…Breaking news from Dallas TX: At the 247^th National Meeting & Exposition of the American Chemical Society researchers presented the health-craving (and the chocolate-craving) world with the first research based and peer reviewed evidence on why chocolate, especially dark chocolate, is an anti-inflammatory health food. Researchers from Louisiana State University, lead by John Finley, Ph.D., explained that the benefits of chocolate have been spoken about for centuries, but a modern scientific understanding of why has remained a mystery. Finley’s team identified Bifidobacterium and lactic acid as “good microbes” that literately consume the chocolate we eat and then ferment it into anti-inflammatory compounds that are good for the heart. Read more here: www.acs.org/content/acs/en/pressroom/newsreleases/2014/march/the-precise-reason-for-the-health-benefits-of-dark-chocolate-mystery-solved.html

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